When Negative is a Positive

When looking for signs of malignancy in a pathology report, a negative result is a good thing. A positive result is a bad thing. My biopsy was positive for cancer. Bad. Treatment? Take it out. Done. 

This week I received the first pathology report that gave data on 3 things that were removed during surgery: Lymph Nodes, Right Breast and Left Breast. Since I knew that the Right Breast contained cancer cells, it wasn’t expecting any huge surprises, just more details. The Left Breast was removed prophylactically (for my convenience) so I wasn’t expecting anything there. But the Lymph Nodes? Now that data was going to be important. 

Path report snippet

Such great news! Negative! Woot Woot! 

Before we go too far along, let me explain a bit about the lymphatic system – that will give you an idea of why this is such a big fucking deal. 

The lymphatic system carries lymph – a clear fluid (from Latin lympha, meaning water). Lymph works in conjunction with the circulatory system (which carries blood). It travels along and filters through lymph nodes (we have between 500 and 600 in our bodies). Here’s a look at the area of interest to me:

Diagram
In other words, armpit. 

Lymph nodes and the lymphatic system are very important in the cancer world, because when you have cancer, the lymphatic system acts as a highway (to hell). It carries cancer cells all over the body where it can take root, grow and kill you. That process is called metastasis. I’m sure you’ve heard of metastatic cancer. Sucks. 

When cancer cells travel in lymph, they will get caught up in the lymph nodes. This is why, when looking for any spread of cancer, the surgeon first figures out which nodes the cancer tumor drains to, and then does a biopsy of those nodes. With breast cancer the surgeon takes out one or more axillary lymph nodes. They are in the armpit as you see in the diagram above. In an earlier post I told you a bit about how I was prepped for the sentinel node biopsy. I found out later that only one node “lit up”, which was a good thing since the surgeon only had to take one out.

sentinel node biopsy
This is what they do to figure out where the “hot” node is.

Of course, since it’s deep in the armpit, the surgery involves digging and scraping through the pectoral muscle so it’s a bit tender. But I digress. My “hot” node was negative, and that’s what’s important. No cancer in my lymphatic system. Phew!

The second set of results were details about the cancer in the right breast – which we knew a bit about already, mainly that it was Ductal Carcinoma in Situ (DCIS) with microinvasions. That means that there was cancer in the duct with some invading out of the duct.  Details from the pathology report:

  • the cells are Stage 3 invasive ductal carcinoma
  • there were multiple foci of microinvasion in the 4cm x 3.6cm area (as shown in the MRI … so mastectomy was the right call). 🙂
  • the two foci were 2.5mm and 2.1 mm
  • there were clear margins around the larger area
  • It is named “high grade comedonecrosis” or “Grade 3”, positive for EIC (extensive intraductal component) Which translates roughly to “really fucking bad”, as my surgeon pretty nearly said, but without the swearing. 
Pathology
Pretty easy to understand, all things considered.

The data revealed that it was bloody good that they did a mastectomy, rather than a partial mastectomy (otherwise known as a lumpectomy). It was a bit of a crap shoot to do it since MRI results can often be a “false positive”. I decided to err on the side of caution and had both breasts removed. Glad I did. 

Next step is to meet my oncologist. He / she will read the next pathology report that identifies my cancer cells’ receptors. These receptors indicate what makes my cancer cells grow, and so from that, they determine the treatment plan. But that’s for another blog post. 

Thanks for hanging in! 

8 thoughts on “When Negative is a Positive

  1. Wow. You need to write medical textbooks because somehow I understood every single part of that without even having to re-read. Congratulations!!! I am sooooo happy that your margins were clear and that your lymph nodes were negative. Miss your energy, love your spirit, so inspired by you. Xo

  2. I’m sad and sorry you have had to go through this treatment BUT I appreciate your informative blog. I know several people who have had mastectomies but not all the details of this invasion to their bodies. My cousin recently had one but is not healing well. She won’t talk about it, that is her way.
    Keep up the blogs, stay positive and courageous brave lady. Hugs!

  3. You certainly have made your journey medically understandable. I’m certainly happy to hear you are pleased with the results and decisions you made.

  4. Oh Janice I’m so happy that the report came back negative for the lymph nodes. You continue to inspire and awe me. 💕 Pamela

  5. So very glad to hear your negative was a positive, Jan…and that, thanks to you, it was so easy to understand your report! Love & hugs!! 💕💕

  6. Have you ever considered teaching medical students? You give far better instruction in language everyone can understand. I see a manual on Breast cancer in the works, a god send to anyone facing what you are going through…as you say a positive out of a negative. Love you!!

  7. Lots of good news here! And certainly good confirmation of your decision for the full mastectomy. REALLY glad about the lymph node results. A break of any kind must be appreciated.
    This blog is so helpful for so many people: Thank you for taking the time to research the results and translate it. Sending chests-apart hugs!!

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